Family Matters

A 2007 study by researchers at University College in London has found a correlation between negative relationships and coronary heart disease (CHD). "Negative interactions increase the risk of incident CHD," says Psychologist Roberto De Vogli. "The effect is independent of sociodemographic characteristics, biological factors, pychosocial factors and health-related behaviors." De Vogli received his PhD from UCLA, and has worked for an impressive list of institutions, including the World Bank and the World Health Organization. Most of the more than 9,000 civil servants in this study were married, and De Vogli concentrated on the primary relationship in his analysis.

His overall finding may not seem so surprising, considering the large body of literature that shows that good relationships are associated with positive health and well-being, but this time there is an interesting twist. Apparently, the negative effects of negative relationships are stronger than the positive effects of positive relationships.

"The possibility that negative close relationships are more powerful predictors of health than other aspects of social support is consistent with previous research findings indicating that individuals tend to mentally replay negative encounters more than they replay positive ones," says De Vogli. "It is possible that negative aspects of close relationships are more important for the health of individuals because of the power of negative close relationships to activate stronger emotions (worrying and anxiety) and the consequent physiological effects."

Does this mean we should simply avoid those relationships that bring conflict into our lives? Is that where this finding leads?

In the absence of violence, there may be other alternatives. In their May 2007 analysis, "Transformative Process in Marriage," three American researchers note that when psychologists have studied marriage their dominant focus has usually been on conflict. However, this may be changing. "The study of supportive behaviors within marital relationships has been illuminating," say Frank Fincham of Florida State University, Scott Stanley of the University of Denver and Steven Beach of the University of Georgia. "Many researchers and clinicians believe that forgiveness is the cornerstone of a successful marriage, a view that is shared by spouses themselves. Although attempts to integrate forgiveness into broader theories of marriage hardly exist, forgiveness can be seen conceptually as falling on a dimension of positive coping responses, such as social support."

Fincham, Stanley and Beach also point to commitment and sacrifice as two related "self-repair" processes in marriage which scholars have begun to examine. "Those who report more willingness to sacrifice also report greater satisfaction, commitment and relationship persistence," the researchers noted, as they also asked, "Is there an inherent capacity in many relationships for marital self-repair and relationship-generated change, even in the absence of outside intervention? . . . Can naturally occurring marital self-repair processes be harnessed to improve existing treatment gains over time?"

Naturally, even with the benefit of self-repair processes like forgiveness, commitment and sacrifice, it would take two to tango. But couples in high-conflict relationships could do worse than give these principles a shot. One might even say it could be good for the heart.

The ability to bounce back from misfortune, change, trauma or loss rather than succumbing to depression is referred to by psychologists as "resilience." Though it's true that parent-infant attachment is crucial to the physical development of the areas of the brain that foster resilience and the success of future relationships, there are other considerations that may be encouraging to those who have difficult childhoods to overcome. One of these is the fact that the human brain has amazing plasticity and can grow and change well into adulthood. The other factor is that adults have attachment needs just as children do. Therefore, the adult brain can be reshaped by key relationships, long after childhood has passed.

Louis Cozolino says there are all sorts of ways to help people with attachment difficulties and help change their outcomes. He pointed out one of them in a recent Vision interview. "If someone with an insecure attachment manages somehow to marry someone with secure attachment, then after about five years or so, research shows that there’s a shift in their attachment pattern to a more secure profile."

This underscores how important healthy family relationships are throughout our lives, not just in childhood. But successful relationships are not only important to individual and family well-being.

Sociologist Peter Marris, whose studies in loss and life change drew on John Bowlby's attachment theory to explain the differences in the way different people handle uncertainty, believed that most of society's problems can be traced to breakdowns in human relationships.

In 1991, he wrote, "Our theories of human behavior split into largely independent systems of thought: psychology and social science. . . . We rarely explore the interaction between each unique human actor and the social systems of which she or he is part. Yet, surely this interaction ought to be at the foundation of any theory of human behavior. How can we begin to understand ourselves except as creatures of the societies from which we learned the language itself to think about ourselves? And how can we understand society except as a network of patterns of relationship which each of us is constantly engaged in creating, reproducing, and changing? We need a way of thinking about the interaction between unique human beings and the social relationships they form, not only because our theories are crippled without it, but because without it we cannot articulate clearly many of the gravest causes of social distress."

Government and social institutions, which have sometimes sought to solve human problems by financial means alone, are now showing signs of realizing this. One human security study prepared by the Harvard School of Public Health for the United States Agency for International Development recently argued that "a narrow focus on material resources has prevented analysts from identifying the true sources of vulnerability or resilience in a population, . . .these complex situations are best explained by a composite model of human security. For a society to be resilient, we find that it need not necessarily be rich." Instead, the report says, "individuals and communities have greater resilience when their core attachments to home, community and the future remain intact."

John Bowlby's "Attachment Theory" has had a profound impact on every field related to the development of the mind for more than half a century. During a period when most psychiatrists believed nearly all neuroses could be traced to infantile sexuality: either through the Freudian emphasis on the Oedipus complex or the Kleinian focus on infantile fantasies, Bowlby's ideas at first seemed somewhat heretical. His burgeoning belief that the mind would not develop properly in the absence of strongly attached caregiver relationships seems elementary now—and is in this century being confirmed by neuroscience. But fifty years ago it won Bowlby a host of critics, despite the fact that it was based on actual observations of children separated from their parents.

Bowlby himself came from an upper-middle class English family where nursemaids and a governess minded the children. Not an uncommon arrangement in his day, but perhaps his own experience provoked his 1940 supposition that "If it became a tradition that small children were never subjected to complete or prolonged separation from their parents in the same way that regular sleep and orange juice have become nursery traditions, I believe that many cases of neurotic character development would be avoided." (Bowlby 1940a).

For Bowlby and subsequent adherents to attachment theory, human psychological development, resistance to depression and other such disorders—even survival itself—depends on the quality of our relationships with others. And this lifelong interdependence begins at birth.

But could attachment begin even in the womb?

Studies from the relatively new field of prenatal psychology have begun to give credibility to long-held maternal convictions that preborn babies hear, learn from and respond to parental attention, and are affected by maternal emotions. If such findings continue to accumulate, could they explain the deep-seated drive some adopted children have to seek out their biological parents, even when they have healthy attachment to a surrogate family?

Speaking of the importance of grandparent and grandchild relationships (as we have been so far this week), Linda Elliott's latest article at Vision makes a good point about the intergenerational role of in-laws.

Elliott points out how important it is to maintain good relationships with your child's mate, not only for the sake of their marriage and the happiness of your child but also with your own future in mind. "The transfer of intergenerational wisdom that can occur if we don’t alienate our daughters-in-law is unlimited," says Elliott. "There may be grandchildren . . . great-grandchildren. These future generations need grandparents in good standing. Make each occasion together pleasant, quality time. Leave them hungering for more, not dreading the next visit or phone call."

As Elliott noted, mothers-in-law tend to be the main focus of derogatory jokes. But fathers-in-law can wreak just as much havoc in an adult child's marriage. In a 2001 Iowa University study, researchers looked into the connection between in-law relations and the future success of marriage, examining each relationship individually: mothers-in-law to sons-in-law, mothers-in-law to daughters-in-law, fathers-in-law to daughters-in-law, fathers-in-law to sons-in-law. Each of these family relationships proved to be important indicators of the quality and ultimate success of the marriage. In other words, fathers-in-law as well as mothers-in-law can affect the quality of the younger couple's marital ties.

The researchers noted that this is true for two important reasons. "First, spouses are obligated to form familial bonds with these nonblood kin. As some researchers have noted, 'rarely is this forced relationship a natural match of kindred spirits.' (Berg-Cross, 1997, p. 177). Second, in-laws can create hostility and stress between spouses who have emotional and psychological loyalties to their own kin."

While the researchers noted more study is needed to fully understand the effects of in-law relationships, they did conclude that "even after an average of two decades of marriage, unhappiness and conflict with in-laws still leads to decreased perceptions of marital success. This is significant because it implies that the influence of in-laws continues far beyond the early years of marriage, when couples are probably most vulnerable to social influences on their marriage. Perhaps that vulnerability to the opinions and behaviors of those who are close to them never ends."

A couple of posts here have already touched on the importance of extended family, but there is so much more to say on the subject. Peter McCartney, who was trained as a nurse at St. Vincent's hospital in Sydney (but now works for the NSW government) rightly pointed out that we don’t always care for our intergenerational relationships as we should. “What is lacking,” Peter wrote, “is the continued support of the elderly well after their family and friends have passed on themselves.”

Another comment came from the United Kingdom. Robert noted that when he moved abroad his family felt the loss of their extended family support network. “Raising a family is tough without all of that,” he said, “grandparents should be around to pass on their life experiences. It’s great seeing the world, but I do wonder sometimes if the cost is too great.”

These comments bring to mind a recent study on the subject of “Grand Cultures.” This term refers to what researcher Candace Kemp calls “patterns of relating between grandparents and grandchildren within families across and within generations.”

It’s interesting that relationships are sometimes referred to as the fabric of society. If we think of the way fabric is woven we really begin to see how important it is that the threads run in more than one direction. If each generation mainly has relationships with peers (the threads only run one direction) the resulting fabric is weak in every area. We don’t have older, wiser people to model ourselves after. We expect everyone to think like us (because after all—our peers do). But one of the worst effects is that as we age, our support network ages with us. Our peers obviously won’t be in a position to care for us when we’re elderly because, in all likelihood, they’ll be needing care themselves. Nor will the younger generations be prepared to care for us. If they’re not accustomed to spending time with their older relatives, why would they value the contributions of the elderly to the extent that they would consider putting themselves to the inconvenience of seeing to our daily needs? As a result, it’s unlikely they will care for us as we age either. Who will then?

The result of such a pattern of disconnected relationships, as Peter McCartney noted, is that support for the elderly is sadly neglected. But neglect isn’t the worst case scenario, as this article on elder abuse points out. It seems to come down to the fact that those of us in the current “middle generation” are in the best position to facilitate good intergenerational relationships. Whether that involves encouraging interaction between our children and our parents, or mixing the generations up when we socialize (especially in the event we find ourselves far from extended family)—in either case we’re the ones with the greatest opportunity to ensure the fabric of society is tightly woven.

As mentioned in the last post, a recent WHO report pointed out that Western familes are more mobile than ever before, and the support networks of extended family are no longer as readily available to young parents.

An extension of this problem may be that many young people grow up without having participated in the care and nurturing of younger cousins, or without the multi-generational influences that teach by example. Do these factors contribute to the creation of a generation that is ignorant about the needs of infants and young children?

The first needs of human beings include cuddling, healthy touch and gentle, affectionate stimulation. Unfortunately, too many children suffer the consequences of complete neglect or from high doses of the wrong kind of stimulation, the effects of which can reverberate in a family for generations.

Psychologists speculate that they may currently be seeing the effects of increased attachment problems. I recently spoke with Louis Cozolino, author of The Neuroscience of Human Relationships, a clinical psychologist who is also a professor at Pepperdine University. "When you have inadequate attachment," says Cozolino, "—and society isn't really set up to allow people the time and the space to raise their children and be present with their children in order to establish that attachment—then I think kids are more vulnerable. I don't get a sense that there's a lot of attachment security, certainly not in the people that I work with. Of course, it's not a random sample but a clinical sample, but it certainly seems that adults are not coming out of childhood feeling safe in the world. As a result, people seem to be having difficulty creating connections."

Roland S. Martin's recent commentary on CNN.com (see link below) addresses the daunting task of reversing the trends of father absence in America's black community. However, the rest of American society—and indeed the West in general—has nothing to be complacent about in this respect. In fact, if the African American community were to succeed in establishing a stronger family ethic, it might find itself held up as a model for much of the rest of the world.

"Strengthening families and the communities in which they live is at the heart of child health and development. Family structure has changed noticeably in many societies over recent decades. Single-parent families, or families where one of the parents is not the birth parent, have increased. The divorce rate has escalated, as has the number of children born outside of marriage. Migration from the countryside to cities continues, often leaving behind the traditional support network of the extended family. . . .As a consequence of all these factors, the social system that used to buttress young families is no longer available to the same extent in many parts of the WHO European Region."

This is of concern for many factors related to child well-being, one of which is poverty. Oddly, it is the wealthier nations that have the highest concentrations of single parent families through divorce or teen pregnancy. Poorer nations arrive at their single-parent statistics more often by the death of a parent than by divorce. But almost across the board, single-mother households have a higher risk of living below the poverty line than do single-father households or two-parent households. According to Marguerite G. Rosenthal's contribution to "The Feminization of Poverty: Only in America?" this is even true in Sweden, where social assistance takes the place of fathers in single-mother households. Although fewer Swedish single-parent families remain below poverty level than do their counterparts in other Western nations, single-mother families are still affected most.

As pointed out in the previous post, there are many reasons why Grandparents may find themselves raising grandchildren. Sometimes the middle generation is missing for reasons that are truly tragic, as is the case with Africa's ongoing AIDS crisis and the resulting "AIDS Grannies."

According to the United Nations 2006 global AIDS summary, the crisis is far from abated. However there are some encouraging trends resulting from interventions that include public education and counselling services. In roughly two-thirds of the 11 sub-Saharan countries studied, sexual activity in children under 15 has been declining. In six of the heavily affected African countries, HIV prevalence among 15-24-year-olds in capital cities have declined by 25% or more.

But Africa remains the hardest hit by the AIDS pandemic, with some areas showing no decline whatsoever. According to the UN report, the best way to reduce these figures is through efforts to reduce sexual risk behaviours. Says the report, "Countries that have lowered HIV incidence have benefited from the emergence of new sexual behaviour patterns . . . delayed sexual debut in Zimbabwe, increasing emphasis on monogamy in Uganda . . ."

But such changes in behavior rarely come about without teaching or training, a difficult challenge with so much of the middle generation missing.

An ongoing discussion among social researchers revolves around the question, "What are the benefits and drawbacks of grandparents raising grandchildren?"

For some, it would be more relevant to ask, "Why is this such a burning question?"

The consensus is that there are increasingly more grandparents taking responsibility for their grandchildren—for a variety of reasons, and according to sociologists, this is an international trend. Part of this increase can be attributed to the fact that social workers have begun to notice children do better when placed with extended family when possible rather than in stranger foster care, which has often the norm in post-modern times. But part of the increase can be traced to the fact that a number of post-modern parents have simply abdicated their roles, and have left their own parents to pick up the pieces.

To be fair, this is not always the case. Single parents sometimes find themselves in situations beyond their control, and must depend on extended family for help. Two-parent families are not immune to unfortunate circumstance either.

Regardless of the reason, however, sociologists note the trend and have begun to debate the affect on grandparents themselves. While in general, it is agreed that there are certainly positive benefits to both grandparents and grandchildren in such situations, there are some caveats. The circumstances that result in such placements can be cause for grieving for the entire household. Children may grieve separation from their parents, while grandparents grieve the perceived failure of their own parenting, or may simply grieve the life difficulties of their children. Research suggests that in such cases grandchildren may not receive the comfort and love from their grandparents that they need if grandparents are also experiencing the stress of the middle generation's problems.

Thus, while placement with extended family may be preferable to placement with strangers, the result may still be less than ideal in some situations. Health problems for over-stressed, worried grandparents may result in interrupted attachment for dependent grandchildren, and the needs of both may end up just short of being met.

What role does the "generation gap" play in all of this? It's an interesting question. If we weren't so complacent with the existence of such gaps, would such problems be as prevalent? And if the "middle generation" abdicates, could it have something to do with their having been raised on the outdated, ultra-permissive child-rearing philosophies of a generation ago that experts such as Dr. Spock ended up retracting? Or could it even be related to insecure attachment with their own parents? Of course there are no simple answers however tempting it may be to look for them.

In any case, such discussions encourage us to consider how important it is to think long and hard about our parenting strategies. Our children will eventually be parents themselves, and members of the "middle generation." As parents and grandparents, we ourselves have each been as well. It's primarily when this middle generation is missing—either physically or emotionally—that there's concern about the resulting strains on either side of the "generation gap." The goal of mending the "fabric of society" requires that we also minimize holes in the ongoing weaving process.

People who are good at maintaining important relationships in their lives have always instinctively known what researchers are now discovering: good relationships are crucial to our health and well-being. In Social Intelligence: The Revolutionary New Science of Human Relationships, Daniel Goleman excavates the still-emerging field of social neuroscience for clues to a better understanding of human relationships.

Says Goleman, "These new discoveries reveal that our relationships have subtle, yet powerful, lifelong impacts on us. That news may be unwelcome for someone whose relationships tend toward the negative. But the same finding also points to reparative possibilities from our personal connections at any point in life. Thus how we connect with others has unimagined significance."

Louis Cozolino, author of The Neuroscience of Human Relationships, makes a similar point. "The individual neuron or a single human brain does not exist in nature. Without mutually stimulating interactions, people and neurons wither and die."

Both Cozolino and Goleman trace the foundation of good relationships to quality attachment in infancy. This makes it extremely important for parents to be literate about what their children need, especially during the earliest years.

The UK's online Telegraph last week cited a new Yale study suggesting that babies as young as six months old can tell the difference between people who are likely to help them and people who are not. This prompted the author to ask, "Are babies born with morals?"

If it seems a huge leap from "babies can tell who is likely to help them" to "babies are born with morals," it's only because it is rather. One has only to take a cursory look inside oneself to understand that our standards of right and wrong when it comes to how others treat us are much more intuitive than our standards of right and wrong when it comes to our treatment of others.

Unfortunately, it doesn't appear likely that this study means we can wind up our kids and let them loose into the world without any kind of guidance, and to be fair, I don't think that's what Roger Highfield meant to imply in the least. He merely intended it to spark conversation, and I am happy to take the bait. It offers the opportunity to ask another question while we're on the subject. "What can parents do to instill a sense of right and wrong in their children?"

While child development gurus have all kinds of advice to offer on the topic, parents who try to apply it all may find themselves and their children reeling from the contradictions and overstimulation.

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Gina Stepp has a master's degree in forensic psychology with an emphasis on trauma and resilience. As family and relationships editor for Vision, she examines the role interpersonal connection plays in ensuring human well-being.